Wednesday, December 24, 2008

Happy Christmas!

Thank you all so much for reading my blog through the year, and for all your comments and support.

I hope you have a great Christmas, and a wonderful New Year.

With lots of love, SK xx

Monday, December 22, 2008

losing it

Richard is flat on his back, on his flattened backpack. The weight of his fall has spilled the contents around him – little square sticks of pastel colours, a tin of fixing spray, a notepad and graphite pencils. Many of the pastel sticks have fractured, and their richly coloured dust stains the carpet where his feet and legs have moved over them.
‘Excuse me stepping over you, Richard.’
There’s no other way to get into the flat, he’s so close to the door. Frank stays the other side. We both crouch down to him. His girlfriend, Marie, steps over him, too, and goes to sit down on a computer chair near his head. Her black mascara has mixed with her tears, giving her face an expression of molten anxiety.
‘I thought he was dead. He came back from shopping, he stood there in the doorway, he said “Am I losing my mind?” and then just collapsed. I didn’t know what to do. He went all blue. He was shaking. His eyes were just all wrong. I was terrified. Rich – you terrified me.’
‘Sorry. I’m all right now.’
‘Richard. Did you hurt yourself when you went down?’ I check him over but he seems fine.
‘Really. I don’t need you here. I didn’t call you.’
‘You couldn’t call anyone, Rich. You were dead. I was shit scared. I thought I’d lost you.’
He lies quite still, his eyes open, idly surveying the ceiling. A slightly built man in his mid twenties, pale cheeks, wide brown eyes, dark curly hair and a sparse goatee coiling from the point of his chin - he seems strangely out of time, like a seventeenth century courtier crash landed into black jeans and t-shirt.
‘I’m fine. Really.’
He crosses his legs and arms, and wriggles a bit on the backpack to get comfortable. ‘I’m not going to hospital.’
Marie stands up and moves over to the window.
‘You fucking better not do this to me!’ she wails. ‘You fucking better not! If you die I’m going to kill myself. There’s no-one else I care about.’
Rich raises his eyebrows. ‘I’m not going. I don’t have to.’
‘Well let’s think about that in a little bit,’ I say, unpegging the sats probe from his finger and noting the results. ‘How are you feeling right now?’
‘Fine.’
‘Any pain?’
‘No.’
‘What can you remember?’
‘I ran up the stairs. I opened the door. I had this strange feeling in my head, like a zoning out. Everything felt stuffed up, yeah? Really close, but kind of hollow. I do remember saying “Am I losing my mind?” – because I felt like I was. Then the next thing I remember, you’re looking down at me. And that’s it. But I’m fine now.’
He pauses, licks his lips. Then without moving his head he turns his eyes up and raises his eyebrows again, as if he wasn’t talking to Marie so much as to a vision of her, he says: ‘Did I really go blue?’
‘Yes you fucking went blue. I never want to see that again. It was so, so scary.’
‘Well you did absolutely the right thing in calling for an ambulance,’ I tell her. ‘Marie, describe for us exactly what you saw when Rich collapsed.’
She describes what sounds like a tonic clonic fit.
‘Do you suffer from epilepsy, Rich?’
‘No.’
‘Ever had a fit before?’
‘Once. A month ago.’
‘And what happened with that?’
‘Nothing. I went to hospital. They let me go after an hour. Didn’t say anything.’
It doesn’t sound plausible, but I let it go.
‘What medications are you on? Any?’
‘I take a few things for depression. Well – I did. I stopped taking them last week. I didn’t see the point.’
‘Rich – what I’d like to do as a first stage is to get you out on to the ambulance so we can run a few tests. I promise we won’t do anything you don’t want to do. And we certainly won’t kidnap you. You don’t have to go to hospital if you don’t want to. But I have to say that I would strongly urge you to come with us today. It sounds like you may have had a fit, and I don’t know why. Imagine what would have happened if you’d had this fit alone. Imagine if you’d collapsed here today and Marie hadn’t been around to look after you. You could’ve died.’
‘I don’t care. I’m not going to hospital.’
Marie lets out an anguished moan. She pulls a crumpled leather sack towards her, dumps out the contents and paddles around in the debris for a pack of cigarettes and a lighter.
Rich laces his fingers, gently rubs his thumbs together.
‘I don’t have to.’
‘Well let’s just get down to the vehicle and do some tests. Okay?’
‘Fine.’
He rolls over and stands up in one clean movement, then – seeing the pastel crayons spread over the floor – begins to gather them up. He insists on sorting them right way up into the tray of a neat little portable wooden easel that he takes out of the rucksack. Marie watches him, alternately smoking the cigarette and biting the quick of her nail.
Job done, Rich wipes his hands on the back of his jeans, then turns to walk through the door. Suddenly, he stops to pick up three carrier bags.
‘I may as well take the recycling out,’ he says.
And just by the front door, without even seeming to look, he drops the plastic, the cardboard and the paper into their respective green bins.

Saturday, December 20, 2008

uncle ted?

Michaela has arranged herself on the sofa, Swanson-style, her white silk chinoiserie gown crumpled around her with meticulous abandon, her dry hair sprouting out like thatch from beneath an alice band she looks to have stolen from a barrel maker. Her legs are Ice Age in their hairiness: she has one hoofing great foot placed flat on the carpet, the other up on a low leather pouffe, the big toe of that foot oozing blood from the nail.
‘Hi guys,’ she rasps, ‘thanks for coming. I don’t want to waste your time, but I didn’t know what else to do.’

We have run from the other side of town on one of the busiest nights of the year. Traumatic haemorrhage / lacerations. Downgraded from Category A to B. And then in the notes: Torn toe nail. Control were as embarrassed to send it as we were to receive it, but their best efforts to PSIAM the call had failed, and we were required to attend.

I put my bag down next to the pouffe and kneel at the altar of pointless calls.

‘How did this happen then, Michaela?’
‘Well. It’s all so stupid. I feel such a fool. I was cutting my nails, and I seem to have overdone it on this one. I’ve been having problems with my leg ever since I was beaten up at a fairground ten years ago and had my hip pinned. It’s been a long haul. I’ve got such a lot going on with me.’
‘Such as?’
‘You’ll have to look at my folder. I’ve no idea. But it’s all there.’
‘Where’s your folder?’
She waves vaguely over to the kitchenette. ‘Over there somewhere. By the drug safe, maybe. You’ll see it.’
Frank goes over to look. I put an inco pad underneath the foot to protect the pouffe, then investigate the wound with a syringe of sterile water and some gauze. The nail has split vertically from the root, leaving about half in situ.

‘What will happen to me? Will I need surgery?’

At this moment the flat door is flung aside and a large man hurries in, looking like a six foot toddler in multi-coloured dungarees, a banana yellow t-shirt and red leather boots. His hair is as curly as Michaela’s is straight. They look as if they have pulled costumes from the same dressing up bag.
‘What’s up, Mikey? Everything okay? I saw the ambulance!’
‘Everything’s fine, don’t panic,’ I tell him. Michaela slumps back on the sofa and puts the back of her hand to her forehead.
‘I didn’t want to bother anyone,’ she says. ‘I just felt so – helpless.’
‘Why didn’t you call me?’
‘I didn’t like to. You know me. Soldiering on.’
The large man looks at me earnestedly. ‘Please. If there’s anything I can do to help. Anything at all. We’re all really so grateful you came.’
‘Yes. They’ve been absolutely marvelous,’ says Michaela, brightening. ‘So – good looking, too.’
‘Well if there’s a silver lining, darling, you’ll find it,’ the large man says, pushing some sweaty bangs back from his face and blowing out his cheeks. ‘God, you keep it hot in here.’

I dress the wound.

‘Michaela – there’s not much to be done with this. I’ve cleaned it and put on a temporary dressing which should keep you going tonight. Then first thing I want you to go to your GP and see the practice nurse to get something more permanent sorted out. And maybe see your GP about your ongoing problems.’
I look over to the kitchenette. Frank is thumbing through a thick yellow care folder. He smiles at me as he turns another page and writes something else down on our form.
‘Don’t I need a new nail or something? Plastic surgery?’
‘It’ll grow back before you know it, so – no – I think you’ll be fine.’
‘I simply didn’t know what to do.’
‘Try to bear in mind that the ambulance is really busy, especially at this time of year. I don’t think this really needed us coming out to you.’
‘I’m so, so sorry for wasting your time.’
I tidy up. Frank comes over and hands Michaela the non-conveyance form which she signs with a grand, stage door flourish.
‘Once again – thank you both so much for racing to my rescue,’ she says, giving me back the pen. ‘It means such a lot to me.’
‘Okay. Just – take it easy with those clippers.’
‘I’d get somebody else to do it, but my feet are too ticklish.’
‘Bye then.’
She smiles with as much warmth and breadth as her layers of foundation and blusher will permit.
‘I promise I’ll hold back in future. But if I thought I might get you two again…’ She lets the idea hang in the air with the scent from the apple and cinammon candles on the mantelpiece; but when she drops her head coquetishly, by the candles’ flickering lights she suddenly reminds me of my dad’s eldest brother, Uncle Ted. With his toolbox head, spade hands and flat nose, that old army boxing champ and P&O steward would struggle to look alluring, too.

Wednesday, December 10, 2008

a difficult man

We are waved over to the corner bungalow of the close. It’s a tight squeeze past a builder’s lorry; a Desperate Dan lookalike in cement spattered tracksuit bottoms, check shirt and woolly hat, folds back the offside mirror so we can squeeze past. He nods sternly as we roll by, gives us a mug-at-arms salute.

The door to number 9 stands open. Outside are two elderly women. One of them is sitting on a low garden wall. She looks pale and distressed. The other is standing beside her with a hand on her shoulder. From this slightly tentative contact I would guess that they don’t know each other that well.
‘Are you okay?’ I ask the seated woman.
‘I’ll be all right. I just can’t stand the sight of it. The smell. Urgh.’
‘He’s in the bedroom on the floor,’ says the other woman, a thoroughly tweeded specimen with metallic white hair and a frank smile. ‘I think he’s been there some good while.’
‘Any relatives around?’
‘No. His sister lives up country somewhere. He’s a difficult character. Doesn’t want help. Unfortunately he’s put a good few people against him in the close.’
I walk inside.
George is lying on his front on the floor of a cluttered little box-sized bedroom, in the narrow space between the bed and the wardrobe. One of the ladies has draped him with a blanket from the bed. Carefully I pick out a place to stand near his head and squat down.
‘George? George? It’s the ambulance.’
He seems utterly inert. I pull back the blanket to check for breathing – and yes, there is some minimal stirring there. He is wearing a cardigan and shirt, but his bottom half is uncovered, with his trousers and pants down by his ankles. His skin has a dreadful, mottled white appearance, ice-cold to the touch. Then – inconceivably – he moves his right arm and lets out a noise, a thin, spidery scribble on the surface of the air, the kind of noise a spirit might make, reaching across the void to contact the living.
‘George. Have you hurt yourself?’
I’m worried that he’s fallen and injured his neck, but he can’t tell me, and a quick examination doesn’t seem to cause any pain. He needs oxygen, warming, lifting off the floor, getting off to hospital as quickly as possible. I ask Rae if she could bring the scoop stretcher and get the trolley as close as possible to the door.
I get some oxygen running, cut off his trousers and pants, put a thermal blanket sandwiched between a couple of ambulance blankets over him, then stand up to plan the route out. It’s a logistical challenge.
I clear a space at his head and feet as best I can, carrying a mahogany cabinet out into the hallway, lifting a rickety white wooden occasional table and all its contents up into a far corner of the bed. Rae comes in with the scoop and shuts the door behind her. She estimates George’s height, extends the scoop, unclips it along its length and hands me one half. I place it on the floor next to him, we roll him gently up onto his right side and over onto his back, raise him up again sufficiently to slip the other section in, then snap the two halves back together. We attach straps to keep him in place, lift him on to the bed, then I stay with him there as Rae opens the door again. The angles are such that we just have enough room to scrape through into the hallway and then on into the garden, the trolley waiting on the pathway, head towards us.

The elderly woman on the wall has gone. The other woman is still there. As we pass I ask her to get together as much information on the patient as she can; she hurries away to do that.

Once on the ambulance we take George off the scoop, snapping it apart, Rae taking it to stash away. I reposition George’s oxygen mask again. It keeps riding up because the left side of his face is flattened, rubbed red and raw by the pressure of his time on the carpet. It has left him with a tortured expression, like a man caught in the side of the face by a sulphurous blast. In fact, he has terrible pressure sores all over his body, just as if a devil, to illustrate the poor man's agony, had pressed a flaming brand to each point of contact, and then – as a ghastly flourish – destroyed his penis, blackening the foreskin to the root.
Rae steps back aboard and we work quickly around each other. I cut his arm free of his cardigan and shirt, wrap the blood pressure cuff on him, attach the sats probe. His temperature is unreadable, his blood pressure so low it’s a miracle he can make any noise or movement at all. Rae cannulates his right arm with a large bore cannula, I prep a warm bag of CSL and unwrap the giving set.
There is a knock on the ambulance door. The elderly woman has returned with a piece of card she has torn off a cereal packet. On it she has written the two things she has found out: his approximate age, and the phone number of the woman who helps him with shopping once a week. We thank her for her help.
‘Is he going to be all right?’ she says. ‘I’m sorry we weren’t able to do more, as neighbours. You know. But he was just – is just – such a difficult man.’
‘Don’t worry. We’ll do what we can. Thanks again for helping out.’

Rae passes the ASHICE through to control, and we head off. I reposition the oxygen mask again, and stroke the hair from his face. His one good eye opens, then closes again.

He dies in MASU a few hours later.

Saturday, December 06, 2008

mixed

‘He’s a very sick man. Very sick. He’s been throwing up blood. He’s got an ileostomy, angina, rheumatism. He’s in and out of conscious. He was only discharged from hospital three days ago. He’s an alcoholic. Ten years ago he had a breakdown. Five years ago he had an operation on his foot. He takes a hundred different medications. It’s a miracle he’s here at all. Isn’t it, Bob?’
Bob raises his eyebrows. He is sitting under a bare duvet on a mushroom coloured sofa, looking so comfortable you would think the chair had grown up around him, like an old tree enveloping a metal post.
‘How are you feeling, Bob?’ I ask him.
‘Fine,’ he says. He certainly looks okay. ‘Absolutely fine,’ he says. ‘I didn’t want the ambulance.’
‘Have you been throwing up blood?’
‘No.’
‘So who called the ambulance?’
‘I did. I called the ambulance. Bob’s a very sick man and he just won’t admit it.’
The woman sits on a facing sofa with an obese Staffie behind her like an over-stuffed novelty cushion. The dog gives me the eye, and so does the woman.
‘Excuse me just a moment. Can I ask what your name is, and what your relation is to Bob?’
‘My name is Liz. I’m Bob’s carer.’ She scrapes her greasy hair back from her face as if she’s streamlining herself for a fight. ‘In fact I look after the two of them.’
The other person she refers to is sitting on yet another sofa, her hands folded in her lap, looking on the scene with a flat set to her lips. I remember being called out to her in the past – given as a Cat A unconscious, it had turned into a psych case, with the patient complaining that a neighbour had forced her to smoke crack, and she hadn’t been able to sleep.
‘So you’re not actually a relation?’
‘No. I live next floor up.’
‘But you’re an official carer for the two of them?’
‘Technically, no. But that’s what I do.
‘So Bob – you seem pretty compos mentis to me. Are you capable of making decisions for yourself?’
‘Yes.’
‘Has Liz been granted any kind of legal jurisdiction over you?’
‘No.’
I turn back to Liz. ‘Well, in that case, I need to be guided by Bob, Liz.’
‘Look. He’s desperately ill. He needs to go to hospital. He was unconscious. He takes all these pills. He recently came out of hospital. He was sicking up blood.’
‘For God’s sake! Let the man alone!’ snaps the other woman. She doesn’t move, though. She is as precariously immobile as the two garden spades incongruously propped up beside her chair. The room has the air of a well-to-do study commandeered during a time of civil unrest for use as a street-drinkers’ flop. High-end antiques and leather-bound classics struggle to maintain their identity amongst the scatterings of vodka bottles, pill packets, fast food containers and dog toys.
‘Bob. Are you in pain?’
‘No.’
‘Are you unwell in any way?’
‘No.’
‘Do you want to go to hospital tonight?’
‘No.’
‘Fine. We’ll take a few obs, and leave you in peace.’
‘This is ridiculous!’ says Liz. She stands up, strides over to a low table covered in spilling ashtrays and scrunched up tissues, and snatches up a grubby leather satchel filled with meds. ‘Just look at all these.’
‘For God’s sake! Let him alone!’ says the woman over by the spades. ‘Please!’
I take the satchel from Liz. ‘Thank you. Now - if you wouldn’t mind having a seat again and letting me get on with things, that’d be great.’
She dumps herself back on the sofa, nearly squashing the dog, who lets out a little whumping noise, and then gives me the eye again, as if him being flattened was part of my plan all along.
The meds are all mixed up: hers, Bob’s and Myrna, the other woman.
‘What were you in hospital for, Bob?’
‘The stoma got a bit infected, but it’s fine now.’
‘No discomfort?’
‘No.’
Frank quickly runs through the usual obs; they all come out fine.
‘Bob – if you don’t want the ambulance in future and someone rings on your behalf, you must try to stop them, or cancel it. It’s a waste of our time, otherwise. And someone who really needs us might suffer as a result.’
‘I know, but…’
‘So you’re not taking him in?’
‘Bob doesn’t want to go in. He doesn’t need to go in.’
Frank packs the equipment away, giving Liz a look he seems to have copied off the dog.
‘He should be in hospital.’
‘Bob – my advice is to get some rest tonight. Maybe see your doctor in the morning. Okay?’
‘Yep.’
I look across to Myrna. She sits as restrained and doll-like on her cushion as before, but it’s easy to imagine her suddenly snatching up one of the spades, swinging it above her greying head like a battleaxe and rushing at Liz. But instead she gives out a breathy little tsch, and brushes some crumbs from her lap.
Liz and the dog see us to the door.
‘Thank you for coming,’ she says. We feel the spike of their eyes in our backs as we push open the stairway door and head back down the communal stairs to the ambulance.

Friday, December 05, 2008

contagion

The sea is a sheet of liquid glass spreading in from the horizon, smooth around the worn wooden beams and concrete pillars of the old harbour wall, smooth around the pleasure boats and fishing boats riding at anchor, smooth around the jetty and the landing platforms, the steps down from the road, the ribs of ruined boats in the highest of the silt banks, black beneath the vast, shadowy bulk of the old swing bridge. The entire morning seems to leap up from this painfully bright surface; even the cormorant out near the harbour mouth has his wings outstretched, crucified by the surfeit of light.
Our patient, a middle-aged woman in a bulky blue winter coat, sits on a concrete block at the far end of the car park. She is hunched forwards like a fisherman asleep by the rod, her forearms supporting the weight of her upper body on her knees. Her left hand hangs down between her legs, fingers relaxed and open. In the other hand she has a Stanley knife.
‘Drop the knife! Now!’
The policeman who arrived on scene with us takes a step towards her, one arm out in front.
‘Drop it!’
She turns her head. Her neck is gaping open.
‘Drop it now!’
She stands up. Her coat is undone, reveals pyjamas stained with blood. She drops the knife and looks at us all with an expression as glassy as the water. Incredibly, she manages to talk.
‘Leave me here,’ she rasps. ‘I need more time.’
‘Put your arms out to the side,’ the policeman says. His hands are bare, so I give him a pair of blue gloves. He snaps them on. ‘Do you have any other weapons?’
‘No.’
He pats her down, then takes a step back to let us grab the woman before she falls. We walk her onto the ambulance and lie her on the stretcher.

She has a grievous wound to her neck, a frank, butcher’s slice that parts it neatly left to right, the adipose tissue and muscles exposed, her trachea laid open – but she has missed the major blood vessels, the other incredible aspect of this injury. As she breathes, the air rushes in and out with a gently wet flapping noise. I soak a dressing in sterile water and place it across the wound.
‘Please. Just one more minute.’
She sounds leaden with fatigue, a lumpish, domestic figure fixated on the last chore of the day.
‘I was supposed to fall backwards into the water,’ she says. ‘I have a bug in my stomach.’
‘Don’t talk. Try not to talk,’ I tell her, gently tying the dressing in place.
‘I have a bug in my stomach. My husband and daughter cleaned up a mess that came out of me, and now they have it, too. I’ve given them my bug.’
She tries to make little shakes of her head. We tell her to be still. Rae strokes her forehead like a child with a fever. ‘Ssh.’

Back outside the ambulance, the policeman asks me how she is.
‘It looked pretty bad,’ he says. ‘Was that her windpipe?’
‘Yeah. She had a pretty good go at it,’ I say, pulling off my gloves. ‘We need to get off.’
‘I’ll follow in the car.’

He tucks in behind us, a sparkling, early morning punch through the rush hour traffic back into town.

Tuesday, December 02, 2008

melissa

‘I’ve definitely been here before.’

Rae tries to remember for what as we walk up the concrete steps of the housing block. We had turned off the blue lights before we entered the estate, but the road had seemed to shiver like a tripwire; even before our bags were out, we were the multi-eyed focus of this stack of lighted windows.

On the second floor landing a door stands open. Just inside, a tall young kid of about seventeen, dressed in white trainers, a baggy white tracksuit, and a Nike baseball cap tilted up on his head, waits in the narrow hallway, cradling his right hand.
‘She’s in there, in the bedroom,’ he says. ‘And I’ve busted me hand.’
He turns, and leads us down the hallway. For a second I wonder if he’s injured his leg, too, but I realise that the stiff-hipped shuffle is a ghetto-style swagger. He shows us in to a room at the end.
‘Jayne. It’s the ambulance.’
A sickening wail rises up from a mattress on the floor. Jayne sits huddled up under the duvet, pressing herself against the wall. She holds the duvet up to her mouth, her hands either side like a tucked-up child, looking off into the shadows on the far side of the room. Her greasy hair shines dully in the light from the bedside lamp. Her face has the yellowy off-white colouring of old ivory, and her eyes are circumscribed by darkness. In front of her on the bed is a washing up bowl holding a slop of vomit, sopping tissues and a cider can. Beside the mattress is a cluster of vodka bottles. The rag rug is seeded with butts.

Rae says brightly: ‘The last time I was here you were just about to have a baby.’
The boyfriend leans in: ‘Yeah, mate, yeah. Taken into Care last month.’
‘Oh. Sorry.’
‘She’s necked all those,’ the boyfriend says, gesturing with his one good hand to a scattering of empty packets. I pick them up: fluoxetine, co-dydramol, paracetamol. ‘She also drank some bleach.’ He hands me a container of Harpic toilet cleaner. The swan-necked spout reminds me of the mouthpiece of a saxophone. I imagine putting it to my lips.

‘I’m not going to no fucking hospital. I’m not. Just leave me alone. I want to die.’ Jayne’s mouth gapes open with the grief of it all; threads of saliva quiver from tooth to tooth.
‘You’re fucking going,’ shouts the boyfriend, leaning over her, jabbing the air in front of her face with his bad hand. Then he winces emphatically.
‘God. Fuck. I won’t do that again.’
He laughs, then holds out his hand to me.
‘What have I done? Is it broken? I suppose I should’ve taken these rings off. My fingers feel like they’re going to explode.’
He has a ring that says DAD and another – a gold sovereign in a silver setting, distorted from the trauma, whatever it was. His fingers have swollen up around both of them.
‘Sorry – what’s your name?’
‘Johnnie’
He looks at me. The acne around his nose and mouth seems of a piece with the naïve clarity of his eyes. But there is something else about him, a twist of violence glinting below the surface, that makes me guarded and alert.
‘Johnnie – we’ll look at your hand in a moment. The first thing we’ve got to do is deal with Jayne.’
‘Of course. Yeah – go on, go on. You do what you’ve got to do. And you – you listen to them. They’re professionals. They know about this shit.’ His tone steps up to almost a shout. ‘Cos I’m not losing you. There’s no way you’re doing that to me.’
‘Mate – let’s be calm. You’re not going to help, otherwise. Just stand over here with me and let Rae see what’s what. Come on.’
He lets me steer him over to the other side of the room. Whilst Rae kneels down to talk to Jayne, I ask Johnnie to start gathering some things: shoes, a coat, a mobile phone, any prescriptions Jayne might have. The distraction works. He forgets his anger, and submits to the task with puppyish enthusiasm.
‘Don’t ask me where she put her trainers. Where did you put your trainers?’ he calls out. Then snorts: ‘Women.’ The word seems wrong from him, too adult, like the sovereign ring on his hand.
‘So tell me what happened to you?’
‘Shit. Some guy came to the door. An intruder. I don’t know. Never seen him before. A skinhead. I asked him what the fuck he wanted but he didn’t say nothing, he just tried to push past. So I battered him in the face. Like anyone would, fighting for their life, you know? I mashed him up proper. He fell backwards into the hall, and then he ran off. Look at this. It’s fucked, isn’t it? I’ve broken my hand, haven’t I? Christ – I can’t even turn it over.’
‘Did you call the police?’
He laughs. ‘The what? No mate, I don’t need no po-lice. They’re no good.’
‘Anyway. Those rings will need to come off, Johnnie. They’re cutting off the circulation.’
‘I can’t do it, mate. I promised my Dad I’d never take this off.’
‘Well I think your Dad would understand. And a good jeweller could repair it.’
‘Yeah? Hey – here they are. I’ve got your trainers, babe.’
He snatches them up and we both go back to the mattress.

Rae has persuaded Jayne to come to hospital. We help her to stand up, dress her in a parka coat and trainers, and walk her out to the vehicle between us. Johnnie follows behind, giving us an excited commentary on the skinhead in the hallway, what he did to him, what he will do when he finds out who he is.
‘No one does that to me. Especially not tonight, not with all this.’
We make Jayne comfortable on the stretcher. Her obs are good. Although she doesn’t tell me outright, I know that Rae doubts the number of tablets taken, the story about the bleach.
‘Here. Look at this,’ says Johnnie, carefully rolling up the sleeve on his injured arm. There is a tattoo of a girl’s name in elaborate, copperplate style - Melissa – with a date. ‘That’s when she was born,’ he says. ‘They let me cut the cord and everything. Fuck me, it was tough. That whole time - it was amazing. The way the head came out looking one way, then turned, like that…’ he does a comical, stiff necked turn to the left, ‘just like someone was inside, moving her. But of course they weren’t. I wouldn’t have missed that for the world.’ He cradles his damaged right hand in his left, then says in a different, quieter voice, half to himself and half to Jayne: ‘We’ll get her back. I promise you. We are definitely going to get her back.’